15. Income‐generation interventions – results of included prospective controlled studies.
| Study ID (risk of bias) | Study design (n) | Income‐generation interventions | No intervention | Effect measure (time point) | Effect of combined groups/calculated effect | Effect directiona | Meta‐analysis (yes/no) | ||||
| Results at baseline | Results at follow‐up | n | Results at baseline | Results at follow‐up | n | ||||||
| Primary outcomes | |||||||||||
| 3.2: Proportion of HH expenditure on food | |||||||||||
| 3.2.1 Outcome measure: proportion of HH expenditure on food | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (378 HHs) | — | — | — | — | — | — | — (2 years) |
— | — | N/A |
| Alaofe 2016 (?) | Prospective controlled study (56 HHs) | — | — | — | — | — | — | — (1 year) |
— | — | |
| 3.3: Proportion of HHs who were food secure | |||||||||||
| 3.3.1 Food security | |||||||||||
| 3.3.1.1 Outcome measure: proportion experiencing food security (0 months with insufficient food in past 12 months)/ Doocy: based on HFIAS | |||||||||||
| Weinhardt 2017 (?) | Prospective controlled study (827 participants) | 165/564 (29.3%) | 309/564 (54.8%) | 564 | 71/262 (27.1%) | 117/263 (44.5%) | 263 | OR 1.36, 95% CI 0.93 to 1.97, P = 0.108 (1.5 years) | — | △ | N/A no effect measure for Doocy |
| 165/564 (29.3%) | 36 months: 308/531 (58.0%) | 71/262 (27.1%) | 129/245 (52.7%) | OR 1.12, 95% CI 0.75 to 1.67, P = 0.585 (3 years) | — | △ | |||||
| Doocy 2017 – FFS (‐) | Prospective controlled study (571 HHs) | 1.90% | 27.80% | 317 HHs | 0.40% | 14.60% | 254 HHs | — (3.5 years) | — | — | |
| Doocy 2017– WEG (‐) | Prospective controlled study (548 HHs) | 0,3% | 29.9% | 0.4% | 14.6% | — (3.5 years) | — | — | |||
| 3.3.1.2 Proportion experiencing food deficit always | |||||||||||
| Asadullah 2015 (‐) | Prospective controlled study (4038 HHs) | 60.1 | 15.3 | 2098 | 41.91 | 28.87 | 1940 | pp –28.85, P < 0.01 (3 years) | — | ▲ | — |
| 60.1 | 21.02 | 41.91 | 28.45 | pp –17.15, P < 0.01 (6 years) | — | ▲ | — | ||||
| 60.1 | 42.9 | 41.91 | 44.38 | pp –13.91, P < 0.01 (9 years) | — | ▲ | — | ||||
| 3.3.1.3 Outcome measure: HFIAS (mean, SD or SE) | |||||||||||
| Doocy 2017 – FFS (‐) | Prospective controlled study (571 HHs) | 14.4 (4.6) | 5.7 (5.1) | 317 | 14.8 (5.3) | 10.1 (6.1) | 254 | MD –4.6, 95% CI –5.0 to –4.2, P < 0.001 (3.5 years) | MD –4.23, 95% CI –4.96 to –3.49 | ▲ | No |
| Doocy 2017 – WEG (‐) | Prospective controlled study (548 HHs) | 15.3 (5.3) | 6.3 (5.5) | 294 | 14.8 (5.3) | 10.1 (6.1) | 254 | MD –3.85, 95% CI –4.26 to –3.43, P < 0.01 (3.5 years) | |||
| Kangmennaang 2017 (‐) | Prospective controlled study (1000 HHs) | 1.255 (0.029) | 1.173 (0.033) | 571 | 1.136 (0.044) | 1.359 (0.071) | 429 | MD –0.304, SE 0.095, P < 0.01 (about 2 years) | — | ▲ | |
| 3.3.1.4 Outcome measure: proportion of HHs improving a HFIAS category (95% CI) | |||||||||||
| Doocy 2017 – FFS (‐) | Prospective controlled study (571 HHs) | — | 55.3 (48.8 to 61.9) | 317 | — | 32.4 (24.6 to 40.3) | 254 | MD 22.9, 95% CI 12.7 to 33.1, P < 0.001 (3.5 years) | MD pp 24.21, 95% CI 16.67 to 31.76 | ▲ | N/A |
| Doocy 2017 – WEG (‐) | Prospective controlled study (548 HHs) | — | 59.5 | 294 | — | 31.5 | 254 | MD 25.8, 95% CI 14.6 to 36.9, P < 0.001 (3.5 years) | |||
| 3.3.2 Dietary diversity | |||||||||||
| 3.3.2.1 Outcome measure: probability weighted DDS (mean, SD) | |||||||||||
| Jodlowski 2016 (+) | Prospective controlled study (283 HHs) | — | — | 105 HHs | — | — | 178 HHs | MD –0.123, 95% CI –0.43 to 0.18, P > 0.1 (18 months) | — | ▽ | — |
| 3.3.2.2 Outcome measure: HDDS (mean, SD) | |||||||||||
| Jodlowski 2016 (+) | Prospective controlled study (283 HHs) | 5.86 (1.848) | — | 105 HHs | 5.747 (1.774) | — | 178 HHs | MD 0.267, 95% CI –0.13 to 0.66, P > 0.1 (18 months) | — | △ | Yes. (Doocy groups combined) |
| Alaofe 2019b (?) | Prospective controlled study (423 HHs) | 6.07 (1.26) | 6.50 (1.23) | 282 | 6.05 (1.26) | 6.24 (1.24) | 214 | MD 0.94, SE 0.24, 95% CI 0.4696 to 1.4104, P < 0.01 (1 year) | — | ▲ | |
| Doocy 2017 – FFS (‐) | Prospective controlled study (571 HHs) | 3.4 (1.4) | 3.4 (1.5) | 317 | 3.4 (1.5) | 4.8 (2.1) | 254 | MD 0.9, 95% CI 0.5 to 1.3, P < 0.001 (3.5 year) | MD 0.80, 95% CI 0.51 to 1.09 | ▲ | |
| Doocy 2017 – WEG (‐) | Prospective controlled study (548 HHs) | 3.4 (1.7) | 5.5 (2.2) | 294 | 3.4 (1.5) | 4.8 (2.1) | 254 | MD 0.69, 95% CI 0.27 to 1.10, P = 0.001 (3.5 year) | |||
| 3.3.2.3 Outcome measure: Women's Household Dietary Diversity Score (WDDS‐10) (mean, SD) | |||||||||||
| Alaofe 2019b (?) | Prospective controlled study (430 women) | 4.58 (1.04) | 4.91 (0.97) | 286 | 4.83 (0.97) | 4.01 (1.12) | 220 | MD 0.83, SE 0.19, P < 0.01, 95% CI 0.46 to 1.20 (1 year) | — | ▲ | — |
| 3.3.2.4 Outcome measure: proportion achieving target dietary diversity at endline according to HDDS | |||||||||||
| Doocy 2017 – FFS (‐) | Prospective controlled study (571 HHs) | 21.3 | 69.7 | 317 | 18.1 | 67.6 | 254 | MD 21.7, 95% CI 12.3 to 31.1, P < 0.001 (3.5 year) | MD 17.03, 95% CI 7.81 to 26.24 | ▲ | N/A |
| Doocy 2017 – WEG (‐) | Prospective controlled study (548 HHs) | 18.7 | 62.2 | 294 | 18.1 | 67.6 | 254 | MD 12.3, 95% CI 2.8 to 21.8, P = 0.011 (3.5 years) | |||
| 3.4 Change in adequacy of dietary intake | |||||||||||
| 3.4.1 Outcome measure: percentage of calorie‐deficient HHs (< 80% of caloric requirement/adult equivalent) | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (374 HHs) | 30.7 | 28.1 | — | 30 | 28.7 | — | — (2 years) |
— | — | — |
| 3.4.2 Outcome measure: percentage of preschool‐aged children meeting caloric requirements | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (1297 children) | 69 | 66 | — | 58 | 62 | — | — (2 years) |
— | — | — |
| Secondary outcomes | |||||||||||
| 3.5Change in anthropometric indicators | |||||||||||
| 3.5.1 Stunting | |||||||||||
| 3.5.1.1 Outcome measure: HAZ (mean, SD or SE) | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (746 children) | –1.34 | –1.67 | — | –1.50 | –1.76 | — | NR (2 years) |
— | — | — |
| 3.5.1.2 Outcome measure: proportion stunted (HAZ < –2SD) (CI) | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (222 children) | — | 25.3 | 94 | — | 25.7 | 128 | NR (2 years) | — | — | N/A |
| Doocy 2017 – FFS (‐) | Prospective controlled study (471 children) | — | 60.2 (50.8 to 69.6) | 265 | — | 58.8 (50.1 to 67.5) | 206 | (adjusted) MD 1.4, 95% CI –10.7 to 13.6, P = 0.81 (3.5 year) | — | ▽ | |
| 3.5.2:Wasting | |||||||||||
| 3.5.2.1 Outcome measure: WHZ (mean, SD or SE) | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (651 children) | –0.22 | –0.15 | — | –0.31 | –0.04 | — | NR (2 years) | — | — | — |
| 3.5.2.2 Outcome measure: proportion wasted (WHZ < –2SD) | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (118 children) | — | 13.0 | 48 | — | 14.1 | 70 | NR (2 years) | — | — | — |
| 3.5.3 Underweight | |||||||||||
| 3.5.3.1 Outcome measure: WAZ (mean, SD or SE) | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (198 children) | –1.03 | –1.14 | — | –1.17 | –1.10 | — | NR (2 years) | — | — | — |
| 3.5.3.2 Outcome measure: percentage underweight (WAZ < 80% standard/ < –2SD) (includes severe underweight) | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (198 children) | — | 19.7 | 74 | — | 24.1 | 124 | NR (2 years) | — | — | No. Subset. Except Kennedy – effect could not be calculated. |
| Weinhardt 2017 (?) | Prospective controlled study (509 children) | 14.8% | 16.8% | 322 | 22.5% | 19.8% | 187 | OR 1.52, 95% CI 0.80 to 2.90, P = 0.205 (1.5 years) | — | ▽ | |
| Prospective controlled study (538 children) | 14.8% | 18.6% | 344 | 22.5% | 24.2% | 194 | OR 1.27, 95% CI 0.54 to 3.01, P = 0.585 (3 years) | — | ▽ | ||
| Doocy 2017 – FFS (‐) | Prospective controlled study (471 children) | — | 22.3 (14.8 to 29.8) | 265 | — | 29.8 (22.0 to 37.7) | 206 | (adjusted) MD –7.6, CI –17.7 to 2.5, P = 0.13 (3.5 year) |
— | △ | |
| 3.5.3.3 Outcome measure: BMI (kg/m2) (mean, SD or SE) | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (753 women) | — | 22.3 | — | — | 22.2 | — | NR (2 years) | — | — | No. No effect estimate for Kennedy and variance estimate cannot be calculated for Asadullah (missing group sizes) |
| Alaofe 2019b (?) | Prospective controlled study (359 women) | 23.01 (2.94) | 22.95 (3.73) | 256 | 22.03 (3.14) | 21.69 (3.24) | 167 | MD 0.43, SE 0.24, 95% CI –0.0504 to 0.8904, P < 0.1 (1 year) | — | △ | |
| Asadullah 2015 (‐) | Prospective controlled study (3547 women) | 19.0 | 18.95 | — | 19.17 | 18.98 | — | MD 0.14, P = 0.29 | — | △ | |
| 3.5.3.4 Proportion of women who were underweight (BMI < 18.5 kg/m2) | |||||||||||
| Alaofe 2019b (?) | Prospective controlled study (359 women) | 4.88 | 3.10 | 256 | 6.57 | 14.08 | 167 | MD –0.22, SE 0.27, 95% CI –0.749 to 0.309, P > 0.1 (1 year) | — | △ | — |
| 3.5.3.5 Outcome measure: mid‐upper arm circumference (mean, SD) | |||||||||||
| Katz 2001 (‐) | Prospective controlled study (718 women) | 22.8 (2.0) | — | 335 | 23.0 (2.2) | — | 383 | MD in intervention group –0.20 cm MD in control group –0.25 cm, P = 0.67 (2 years) |
— | — | — |
| 3.6 Change in biochemical indicators | |||||||||||
| 3.6.1 Proportion with iron deficiency | |||||||||||
| Alaofe 2019b (?) | Prospective controlled study (68 women) | 15.3% | 13.5% | — | 17.9% | 12.8% | — | DID –0.11, SE 0.83, 95% CI –0.94 to 0.72, P > 0.05 (1 year) | — | △ | — |
| 3.6.2 Proportion with vitamin A deficiency | |||||||||||
| Alaofe 2019b (?) | Prospective controlled study (60 women) | 14.3% | 5.8% | — | 20.2% | 10.8% | — | DID 0.54, SE 0.95, 95% CI –0.41 to 1.49, P > 0.05 (1 year) | — | ▽ | — |
| 3.9 Morbidity | |||||||||||
| 3.9.1 Outcome measure: proportion seriously ill in past year | |||||||||||
| Asadullah 2015 (‐) | Prospective controlled study (4038 HHs) | 23.38% | 15.89 | — | 24.24 | 17.17 | — | pp –1.72, P > 0.1 (3 years) | — | △ | — |
| 23.38 | 12.93 | — | 24.24 | 12.53 | — | pp –0.78, P > 0.1 (6 years) | — | △ | — | ||
| 23.38 | 22.16 | — | 24.24 | 22.37 | — | pp –0.70, P > 0.1 (9 years) | — | △ | — | ||
| 3.9.2 Outcome measure: % time ill | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (1055 children) | — | 29.8 | — | — | 31.2 | — | NR (2 years) | — | — | — |
| Prospective controlled study (420 women) | — | 23.8 | — | — | 24.3 | — | NR (2 years) | — | — | — | |
| 3.9.3 Outcome measure: % time ill with diarrhoea | |||||||||||
| Kennedy 1989 (?) | Prospective controlled study (1055 children) | — | 4.6 | — | — | 4.0 | — | NR (2 years) | — | — | — |
| 3.9.4 Prevalence of anaemia (women) | |||||||||||
| Alaofe 2019b (?) | Prospective controlled study (126 women) | 49.3% | 36.9% | — | 49% | 53.2% | — | MD –1.25, SE 0.58, 95% CI –1.83 to –0.67, P < 0.05 (1 year) | — | ▲ | — |
| 3.9.5 Prevalence of iron‐deficiency anaemia (women) | |||||||||||
| Alaofe 2019b (?) | Prospective controlled study (564 women) | 6.6% | 4.2% | — | 13.8% | 8.4% | — | MD –0.99, SE 1.40, 95% CI –2.39 to 0.41, P > 0.05 (1 year) | — | △ | — |
aEach triangle represents one study. bThis study also has a component comparing the intervention plus a working group versus a comparison group with a working group. Results are not presented here.
(+): low overall risk of bias; (?): unclear overall risk of bias; (‐): high overall risk of bias; ▲ = Favours the intervention, 95% CI excludes 0; △ = Unclear effect potentially favouring the intervention, 95% CI includes zero; ▼ = Favours the control, 95% CI excludes 0; ▽ = Unclear effect potentially favouring the control, 95% CI includes 0.
CI: confidence interval; DDS: Dietary Diversity Score; DID: difference in differences; FFS: Farmer Field School; HAZ: height‐for‐age z‐score; HDDS: Household Dietary Diversity Score; HFIAS: Household Food Insecurity Scale; HH: household; MD: mean difference; N/A: not applicable/available; NR: not reported; OR: odds ratio; PCS: prospective controlled study; SD: standard deviation; SE: standard error; WAZ: weight‐for‐age z‐score; WEG: Women Empowerment Group; WHZ: weight‐for‐height z‐score.